• August 4, 2018 at Our Lady of Mercy

  The maximum number of form submissions has been reached. This form is currently not available.

  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Phone Number REQUIRED Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
  • Number of adults (13 years or older) REQUIRED

    Enter the total number of adults attending.

    Please fill out this field. Please enter an integer (number).
  • Number of children (12 years or younger)

    Enter the number of children under the age of 12 years old.

    Please enter an integer (number).
  • Total number of attendees REQUIRED Please fill out this field. Please enter an integer (number).
  • Your submission will be sent to the office.  
    You may call with questions at 814-824-1119.

  Submit